Satto I, Ozawa H, Aono H, Ikebe T, Yamashita T
Department of Public Health and Hygiene, Oita Medical University.
Nihon Koshu Eisei Zasshi. 1997 Apr;44(4):292-303.
To evaluate heart disease deaths and clarify trends for ischemic heart disease (IHD) mortality during the last five years in Oita City, we reevaluated causes of death on death certificates. In 1993, there were 253,000 people aged 25-74 in Oita City. In this population age group, there were 1,996 deaths from January 1992 through December 1993. Our subjects were 982 deaths recorded as caused by heart disease and IHD related diseases. Subjects were reevaluated on the basis of physician's interview, clinical records and police records. This IHD reevaluation was conducted by the WHO MONICA criteria. The death certificates identified 321 heart disease deaths, of which there were 80 (24.9%) acute myocardial infarctions (AMI), 22 (6.9%) other IHD, 180 (56.1%) heart failures, and 39 (12.1%) other heart diseases. The remaining 61 deaths were caused by other diseases. After reevaluation, 40 'definite' AMI and 60 'possible' AMI were recognized through the MONICA criteria, 86 sudden deaths (SD) which were defined as, 'death within 24 hours of the onset of acute symptoms and without clear signs suggesting what disease was the cause,' were also classified. Assuming that 50% of SD were due to IHD, according to some postmortem autopsy studies, aged-standardized IHD mortality per 100,000 for males was 38.3 per year and for females 17.3 per year in this period. Both mortality rates, 31% for males and 38% for females, were higher than IHD mortality statistics. Moreover, in comparison with IHD mortality estimated by reevaluation of heart disease in Oita City in 1987-88, age-standardized IHD mortality per 100,000 for males has remained basically stable, increasing from 37.8 to 38.4 during the last five years. On the other hand, mortality for females has increased from 11.2 to 17.3. Our results suggest that mortality from IHD actually was about 30% more than mortality statistics, and does not show a declining trend as mortality statistics have stated.
为评估大分市过去五年中心脏病死亡情况并阐明缺血性心脏病（IHD）死亡率的趋势，我们重新评估了死亡证明上的死因。1993年，大分市有25.3万年龄在25 - 74岁之间的人口。在这个年龄组中，1992年1月至1993年12月期间有1996人死亡。我们的研究对象是982例记录为由心脏病和IHD相关疾病导致的死亡。研究对象根据医生访谈、临床记录和警方记录进行了重新评估。此次IHD重新评估是按照世界卫生组织MONICA标准进行的。死亡证明确定有321例心脏病死亡，其中有80例（24.9%）为急性心肌梗死（AMI），22例（6.9%）为其他IHD，180例（56.1%）为心力衰竭，39例（12.1%）为其他心脏病。其余61例死亡由其他疾病导致。重新评估后，通过MONICA标准确认了40例“确诊”AMI和60例“可能”AMI，还对86例猝死（SD）进行了分类，猝死定义为“急性症状发作后24小时内死亡且无明确迹象表明病因”。根据一些尸检研究，假设50%的SD归因于IHD，在此期间，每10万男性的年龄标准化IHD死亡率为每年38.3，女性为每年17.3。男性和女性的死亡率分别为31%和38%，均高于IHD死亡率统计数据。此外，与1987 - 1988年大分市心脏病重新评估估计的IHD死亡率相比，每10万男性的年龄标准化IHD死亡率基本保持稳定，在过去五年中从37.8增至38.4。另一方面，女性死亡率从11.2增至17.3。我们的结果表明，IHD的实际死亡率比死亡率统计数据高出约30%，且并未如死亡率统计数据所述呈现下降趋势。
